Reye Syndrome (cont.)

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What causes Reye's syndrome?

Although there has been extensive research into
the cause of Reye's syndrome, it is still not completely understood. As mentioned
above, the use of aspirin or aspirin-containing medications to treat children
with some viral infections including chickenpox,
influenza, and gastroenteritis
has been shown to be associated with the development of the disease. Ultimately,
the causes of symptoms associated with Reye's syndrome relate to dysfunction of
the liver and a resultant increase in serum ammonia levels and other toxins.
These toxins cause increased pressure in the brain and swelling, leading to
brain dysfunction and can progress to death.

What are risk factors for Reye's syndrome?

Most children diagnosed with Reye's
syndrome have a history of a recent viral infection. Chickenpox and influenza
are identified most often, though rotavirus (a cause of bowel inflammation or
gastroenteritis) has also been described. In addition to the recent viral
infection, most have a history of taking aspirin to control fever. Some
researchers have suggested that children with undiagnosed metabolic disorders
may also be at risk, though this is not completely clear.

What are Reye's syndrome symptoms and signs?

The primary symptoms of Reye
syndrome include uncontrolled vomiting and mental status changes. These symptoms
are generally the result of increased intracranial pressure and brain swelling.
If untreated and progressive, the disease is fatal. Even if identified and
treated early, some patients will still have progressive disease resulting in
death or permanent brain damage.